NURS 318 Exam #2 Study Guide With
Complete Solutions
S1 heart sound - ANSWER The first heart sound (S1) represents closure of the
atrioventricular (mitral and tricuspid) valves
S2 heart sound - ANSWER The second heart sound (S2) represents closure of
the semilunar (aortic and pulmonary) valves. S2 is normally split because the
aortic valve (A2) closes before the pulmonary valve (P2)
Benign causes of murmurs - ANSWER Pregnant women
Newborns
Adolescents
Anemia
Hyperthyroidism
malignant causes of murmurs - ANSWER Septal defects
Valve stenosis
Valve regurgitation
Valve calcification
Endocarditis
Rheumatic fever
Heart auscultation sights - ANSWER
Order of Auscultation - ANSWER All Physicians Take Money:
Aortic, Pulmonic, Tricuspic, Mitral
How to assess circulation - ANSWER -Bilateral pedal pulse checks
-Capillary refill
-Skin color, temperature, sensation and motor function
-Pain assessment
-Edema assessment
EKGs detects: - ANSWER Abnormal cardiac conductions
MI/ischemia
Cardiac hypertrophy
Pacemaker check, etc.
-Also pts at risk for CV disorder, S/S of cardiac problems, and before major
procedures
Normal PR and QRS intervals - ANSWER PR: 0.12-0.2
, QRS: 0.004-0.10
Normal lipids levels - ANSWER -Total cholesterol <200 mg/dL
-Triglycerides <150 mg/dL
-LDLs <100 mg/dL
-HDLs >40 mg/dL
Normal CK-MB level - ANSWER should be zero
Normal troponin level - ANSWER <0.2
Normal INR level - ANSWER 0.8-1.1
Normal PTT time - ANSWER 30-40 sec
Pacemaker nursing care - ANSWER -After pacemaker is inserted, the pt can be
out of bed ONCE STABLE
-Limit arm and shoulder activity on the operative side to prevent dislodging the
pacing leads
Pacemaker pt teaching - ANSWER -Keep patient's cell phone away from
pacemaker: use other ear for calls and don't put it in the shirt pocket
-Avoid arc welding, large stereo speakers, leaning over running car engines,
some heavy duty electrical equipment and stay 100 yards away from cell towers
-Quickly go through anti-theft/ security gates
-Don't allow hand-held electronic-article surveillance systems
-Safe items: hair dryers, computers, power tools, Tvs, stereos, vacuums,
heating pads, electric razors, blankets, and microwaves
HTN classifications - ANSWER -Normal: Systolic <120 and Diastolic <80
-Elevated: Systolic 120-129 and Diastolic <80
-Stage I: Systolic 130-139 and Diastolic 80-89
-Stage II: Systolic >140 and Diastolic >90
-Primary: idiopathic (unknown cause)
-Secondary: known cause (ex: preeclampsia/eclampsia, renal disease hormone
problems, drug use)
Manifestations of HTN - ANSWER None in the early stages
Headache
Fatigue
Dizziness
Visual changes
Palpitations
Epistaxis (nosebleed)
Flushing
Complete Solutions
S1 heart sound - ANSWER The first heart sound (S1) represents closure of the
atrioventricular (mitral and tricuspid) valves
S2 heart sound - ANSWER The second heart sound (S2) represents closure of
the semilunar (aortic and pulmonary) valves. S2 is normally split because the
aortic valve (A2) closes before the pulmonary valve (P2)
Benign causes of murmurs - ANSWER Pregnant women
Newborns
Adolescents
Anemia
Hyperthyroidism
malignant causes of murmurs - ANSWER Septal defects
Valve stenosis
Valve regurgitation
Valve calcification
Endocarditis
Rheumatic fever
Heart auscultation sights - ANSWER
Order of Auscultation - ANSWER All Physicians Take Money:
Aortic, Pulmonic, Tricuspic, Mitral
How to assess circulation - ANSWER -Bilateral pedal pulse checks
-Capillary refill
-Skin color, temperature, sensation and motor function
-Pain assessment
-Edema assessment
EKGs detects: - ANSWER Abnormal cardiac conductions
MI/ischemia
Cardiac hypertrophy
Pacemaker check, etc.
-Also pts at risk for CV disorder, S/S of cardiac problems, and before major
procedures
Normal PR and QRS intervals - ANSWER PR: 0.12-0.2
, QRS: 0.004-0.10
Normal lipids levels - ANSWER -Total cholesterol <200 mg/dL
-Triglycerides <150 mg/dL
-LDLs <100 mg/dL
-HDLs >40 mg/dL
Normal CK-MB level - ANSWER should be zero
Normal troponin level - ANSWER <0.2
Normal INR level - ANSWER 0.8-1.1
Normal PTT time - ANSWER 30-40 sec
Pacemaker nursing care - ANSWER -After pacemaker is inserted, the pt can be
out of bed ONCE STABLE
-Limit arm and shoulder activity on the operative side to prevent dislodging the
pacing leads
Pacemaker pt teaching - ANSWER -Keep patient's cell phone away from
pacemaker: use other ear for calls and don't put it in the shirt pocket
-Avoid arc welding, large stereo speakers, leaning over running car engines,
some heavy duty electrical equipment and stay 100 yards away from cell towers
-Quickly go through anti-theft/ security gates
-Don't allow hand-held electronic-article surveillance systems
-Safe items: hair dryers, computers, power tools, Tvs, stereos, vacuums,
heating pads, electric razors, blankets, and microwaves
HTN classifications - ANSWER -Normal: Systolic <120 and Diastolic <80
-Elevated: Systolic 120-129 and Diastolic <80
-Stage I: Systolic 130-139 and Diastolic 80-89
-Stage II: Systolic >140 and Diastolic >90
-Primary: idiopathic (unknown cause)
-Secondary: known cause (ex: preeclampsia/eclampsia, renal disease hormone
problems, drug use)
Manifestations of HTN - ANSWER None in the early stages
Headache
Fatigue
Dizziness
Visual changes
Palpitations
Epistaxis (nosebleed)
Flushing
